Provider Demographics
NPI:1992703631
Name:OFFICE OF THE BOROUGH OF EMMAUS
Entity type:Organization
Organization Name:OFFICE OF THE BOROUGH OF EMMAUS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AMBULANCE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:S
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, PHRN
Authorized Official - Phone:610-967-5615
Mailing Address - Street 1:100 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:EMMAUS
Mailing Address - State:PA
Mailing Address - Zip Code:18049-2414
Mailing Address - Country:US
Mailing Address - Phone:610-967-5615
Mailing Address - Fax:610-967-4432
Practice Address - Street 1:100 N 6TH ST
Practice Address - Street 2:
Practice Address - City:EMMAUS
Practice Address - State:PA
Practice Address - Zip Code:18049-2414
Practice Address - Country:US
Practice Address - Phone:610-967-5615
Practice Address - Fax:610-967-4432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA033973416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012031700001Medicaid
PA214260Medicare PIN